鼻内镜下鼻腔泪囊造口术治疗慢性泪囊炎的临床研究

Clinical research of dacryocystorhinostomy for the treatment of chronic dacryocystitis using nasal endoscope

目的：观察鼻内镜下鼻腔泪囊造口术治疗慢性泪囊炎的疗效并探讨手术操作技巧。方法：回顾分析鼻内镜下鼻腔泪囊造口术治疗的慢性泪囊炎患者140例169眼,对随访6-12mo的临床资料进行总结和分析,评价治疗效果并探讨鼻内镜下鼻腔泪囊造口术治疗慢性泪囊炎的手术技巧。结果：本组痊愈155眼（91.7%）,好转3眼（1.8%）,无效11眼（6.5%）,总有效率93.5%,与传统泪囊鼻腔吻合术组术后疗效比较,无显著性差异（χ^2=3.743,P〉0.05）。结论：鼻内镜下鼻腔泪囊造口术治疗慢性泪囊炎有较好的治疗效果。泪囊的定位及大小、造口位置及大小、造口黏膜瓣的处理、鼻部疾病的处理等操作技巧、术后随访及处理和患者体质均可能影响手术疗效。

AIM ： To observe the effect of dacryocystorhinostomy for the treatment of chronic dacryocystitis using nasal endoscope and discuss the operation technique.METHODS： A retrospective clinical analysis was performed on the clinical data follow ed up for 6 - 12 mo from 140 patients（ 169 eyes） with dacryocystorhinostomy for the treatment of chronic dacryocystitis using nasal endoscope. The effect of the treatment was evaluated and the operation technique for the treatment of chronic dacryocystitis using nasal endoscope was discussed. RESULTS： In all of cases 155 eyes（ 91. 7%） were recovery,3 eyes（ 1. 8%） w ere im proved,and 11 eyes（ 6. 5%） were failure. The total efficiency was 93. 5%,there was no significant difference compared with traditional dacryocystorhinostom y group（ χ^2= 3. 743,P〉0. 05）. CONCLUSION： Dacryocystorhinostomy using nasal endoscope for treatm ent of chronic dacryocystitis has a good curative effect. Techniques including lacrimal sac location and size,colostom y position and size,treatment of colostomy m ucosal flap and nasal disease,postoperative follow- up and physical condition of patients are likely to affect the operation curative effect.